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Resource "opioidcds-05" Version "1" (PlanDefinition)

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Generated Narrative with Details

id: opioidcds-05

url: http://hl7.org/fhir/ig/opioid-cds/PlanDefinition/opioidcds-05

identifier: cdc-opioid-guidance (OFFICIAL)

version: 0.1.0

name: PlanDefinition - Recommendation #5 Workflow

title: CDC Opioid Prescribing Guideline Recommendation #5

type: ECA Rule (Details : {http://hl7.org/fhir/plan-definition-type code 'eca-rule' = 'ECA Rule', given as 'ECA Rule'})

status: draft

date: Apr 23, 2017

publisher: Centers for Disease Control and Prevention (CDC)

description: When opioids are started, providers should prescribe the lowest effective dosage.

purpose: CDC’s Guideline for Prescribing Opioids for Chronic Pain is intended to improve communication between providers and patients about the risks and benefits of opioid therapy for chronic pain, improve the safety and effectiveness of pain treatment, and reduce the risks associated with long-term opioid therapy, including opioid use disorder and overdose. The Guideline is not intended for patients who are in active cancer treatment, palliative care, or end-of-life care.

usage: Providers should use caution when prescribing opioids at any dosage, should carefully reassess evidence of individual benefits and risks when considering increasing dosage to ≥50 morphine milligram equivalents (MME)/day, and should avoid increasing dosage to ≥90 MME/day or carefully justify a decision to titrate dosage to >90 MME/day

useContext: ,

jurisdiction: United States of America (Details : {urn:iso:std:iso:3166 code 'US' = 'United States of America', given as 'United States of America'})

topic: Opioid Prescribing (Details )

contributor: , , ,

copyright: © CDC 2016+.

relatedArtifact:

library: Generated Summary: id: opioidcds-recommendation-05; OpioidCDS_REC_05 (OFFICIAL); version: 0.1.0; name: Library - Logic for Recommendation #5; title: Opioid CDS Logic for recommendation #5; status: active; Logic Library; date: Apr 15, 2018 1:49:09 PM; publisher: Centers for Disease Control and Prevention (CDC); description: Opioid Decision Support Logic for use in implementing CDC Opioid Prescribing Guidelines.; purpose: This library works in concert with the OMTK logic library to provide decision support for Morphine Milligram Equivalence calculations and dynamic value resolution.; usage: This library is to notify the prescriber/user whether the current prescription exceeds the recommended MME.; United States of America; Opioid Prescribing;

Exception generating Narrative: type org.hl7.fhir.r4.model.Contributor not handled yet


<?xml version="1.0" encoding="UTF-8"?>
<PlanDefinition xmlns="http://hl7.org/fhir">
  <id value="opioidcds-05"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2018-09-06T12:42:28.687Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: opioidcds-05</p>
      <p>
        <b>url</b>:
        <a href="http://hl7.org/fhir/ig/opioid-cds/PlanDefinition/opioidcds-05">http://hl7.org/fhir/ig/opioid-cds/PlanDefinition/opioidcds-05</a>
      </p>
      <p>
        <b>identifier</b>: cdc-opioid-guidance (OFFICIAL)</p>
      <p>
        <b>version</b>: 0.1.0</p>
      <p>
        <b>name</b>: PlanDefinition - Recommendation #5 Workflow</p>
      <p>
        <b>title</b>: CDC Opioid Prescribing Guideline Recommendation #5</p>
      <p>
        <b>type</b>: ECA Rule
        <span style="background: LightGoldenRodYellow">(Details : {http://hl7.org/fhir/plan-definition-type code 'eca-rule' = 'ECA Rule', given as 'ECA Rule'})</span>
      </p>
      <p>
        <b>status</b>: draft</p>
      <p>
        <b>date</b>: Apr 23, 2017</p>
      <p>
        <b>publisher</b>: Centers for Disease Control and Prevention (CDC)</p>
      <p>
        <b>description</b>: When opioids are started, providers should prescribe the lowest effective dosage.</p>
      <p>
        <b>purpose</b>: CDC&#8217;s Guideline for Prescribing Opioids for Chronic Pain is intended to improve communication between providers and patients about the risks and benefits of opioid therapy for chronic pain, improve the safety and effectiveness of pain treatment, and reduce the risks associated with long-term opioid therapy, including opioid use disorder and overdose. The Guideline is not intended for patients who are in active cancer treatment, palliative care, or end-of-life care.</p>
      <p>
        <b>usage</b>: Providers should use caution when prescribing opioids at any dosage, should carefully reassess evidence of individual benefits and risks when considering increasing dosage to &#8805;50 morphine milligram equivalents (MME)/day, and should avoid increasing dosage to &#8805;90 MME/day or carefully justify a decision to titrate dosage to &gt;90 MME/day</p>
      <p>
        <b>useContext</b>: , </p>
      <p>
        <b>jurisdiction</b>: United States of America
        <span style="background: LightGoldenRodYellow">(Details : {urn:iso:std:iso:3166 code 'US' = 'United States of America', given as 'United States of America'})</span>
      </p>
      <p>
        <b>topic</b>: Opioid Prescribing
        <span style="background: LightGoldenRodYellow">(Details )</span>
      </p>
      <p>
        <b>contributor</b>: , , , </p>
      <p>
        <b>copyright</b>: &#169; CDC 2016+.</p>
      <p>
        <b>relatedArtifact</b>: </p>
      <p>
        <b>library</b>:
        <a href="Library-opioidcds-recommendation-05.html">Generated Summary: id: opioidcds-recommendation-05 OpioidCDS_REC_05 (OFFICIAL) version: 0.1.0 name: Library - Logic for Recommendation #5 title: Opioid CDS Logic for recommendation #5 status: active
          <span title="Codes: {http://hl7.org/fhir/library-type logic-library}">Logic Library</span> date: Apr 15, 2018 1:49:09 PM publisher: Centers for Disease Control and Prevention (CDC) description: Opioid Decision Support Logic for use in implementing CDC Opioid Prescribing Guidelines. purpose: This library works in concert with the OMTK logic library to provide decision support for Morphine Milligram Equivalence calculations and dynamic value resolution. usage: This library is to notify the prescriber/user whether the current prescription exceeds the recommended MME.
          <span title="Codes: {urn:iso:std:iso:3166 US}">United States of America</span>
          <span title="Codes: ">Opioid Prescribing</span> </a>
      </p>
      <p>
        <b style="color: maroon">Exception generating Narrative: type org.hl7.fhir.r4.model.Contributor not handled yet</b>
      </p>
    </div>
  </text>
  <url value="http://hl7.org/fhir/ig/opioid-cds/PlanDefinition/opioidcds-05"/>
  <identifier>
    <use value="official"/>
    <value value="cdc-opioid-guidance"/>
  </identifier>
  <version value="0.1.0"/>
  <name value="PlanDefinition - Recommendation #5 Workflow"/>
  <title value="CDC Opioid Prescribing Guideline Recommendation #5"/>
  <type>
    <coding>
      <system value="http://hl7.org/fhir/plan-definition-type"/>
      <code value="eca-rule"/>
      <display value="ECA Rule"/>
    </coding>
  </type>
  <status value="draft"/>
  <date value="2017-04-23"/>
  <publisher value="Centers for Disease Control and Prevention (CDC)"/>
  <description value="When opioids are started, providers should prescribe the lowest effective dosage."/>
  <purpose value="CDC&#8217;s Guideline for Prescribing Opioids for Chronic Pain is intended to improve communication between providers and patients about the risks and benefits of opioid therapy for chronic pain, improve the safety and effectiveness of pain treatment, and reduce the risks associated with long-term opioid therapy, including opioid use disorder and overdose. The Guideline is not intended for patients who are in active cancer treatment, palliative care, or end-of-life care."/>
  <usage value="Providers should use caution when prescribing opioids at any dosage, should carefully reassess evidence of individual benefits and risks when considering increasing dosage to &#8805;50 morphine milligram equivalents (MME)/day, and should avoid increasing dosage to &#8805;90 MME/day or carefully justify a decision to titrate dosage to &gt;90 MME/day"/>
  <useContext>
    <code>
      <system value="http://hl7.org/fhir/usage-context-type"/>
      <code value="focus"/>
      <display value="Clinical Focus"/>
    </code>
    <valueCodeableConcept>
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="182888003"/>
        <display value="Medication requested (situation)"/>
      </coding>
    </valueCodeableConcept>
  </useContext>
  <useContext>
    <code>
      <system value="http://hl7.org/fhir/usage-context-type"/>
      <code value="focus"/>
      <display value="Clinical Focus"/>
    </code>
    <valueCodeableConcept>
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="82423001"/>
        <display value="Chronic pain (finding)"/>
      </coding>
    </valueCodeableConcept>
  </useContext>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
      <display value="United States of America"/>
    </coding>
  </jurisdiction>
  <topic>
    <text value="Opioid Prescribing"/>
  </topic>
  <contributor>
    <type value="author"/>
    <name value="Kensaku Kawamoto, MD, PhD, MHS"/>
  </contributor>
  <contributor>
    <type value="author"/>
    <name value="Bryn Rhodes"/>
  </contributor>
  <contributor>
    <type value="author"/>
    <name value="Floyd Eisenberg, MD, MPH"/>
  </contributor>
  <contributor>
    <type value="author"/>
    <name value="Robert McClure, MD, MPH"/>
  </contributor>
  <copyright value="&#169; CDC 2016+."/>
  <relatedArtifact>
    <type value="documentation"/>
    <display value="MME Conversion Tables"/>
    <url value="https://www.cdc.gov/drugoverdose/pdf/calculating_total_daily_dose-a.pdf"/>
  </relatedArtifact>
  <library>
    <reference value="Library/opioidcds-recommendation-05"/>
  </library>
  <action>
    <title value="High risk for opioid overdose."/>
    <description value="Total morphine milligram equivalent (MME) exceeds recommended amount. Taper to less than 50."/>
    <documentation>
      <type value="documentation"/>
      <display value="CDC guideline for prescribing opioids for chronic pain"/>
      <url value="https://guidelines.gov/summaries/summary/50153/cdc-guideline-for-prescribing-opioids-for-chronic-pain---united-states-2016#420"/>
    </documentation>
    <documentation>
      <type value="documentation"/>
      <document>
        <extension url="http://hl7.org/fhir/StructureDefinition/cqif-strengthOfRecommendation">
          <valueCodeableConcept>
            <coding>
              <system value="http://hl7.org/fhir/recommendation-strength"/>
              <code value="strong"/>
              <display value="Strong"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/cqif-qualityOfEvidence">
          <valueCodeableConcept>
            <coding>
              <system value="http://hl7.org/fhir/evidence-quality"/>
              <code value="low"/>
              <display value="Low quality"/>
            </coding>
          </valueCodeableConcept>
        </extension>
      </document>
    </documentation>
    <triggerDefinition>
      <type value="named-event"/>
      <eventName value="medication-prescribe"/>
    </triggerDefinition>
    <condition>
      <kind value="applicability"/>
      <description value="Is total MME &gt;= 50?"/>
      <language value="text/cql"/>
      <expression value="Inclusion Criteria"/>
    </condition>
    <groupingBehavior value="visual-group"/>
    <selectionBehavior value="exactly-one"/>
    <dynamicValue>
      <path value="action.title"/>
      <expression value="Get Summary"/>
    </dynamicValue>
    <dynamicValue>
      <path value="action.description"/>
      <expression value="Get Detail"/>
    </dynamicValue>
    <dynamicValue>
      <path value="activity.extension"/>
      <expression value="Get Indicator"/>
    </dynamicValue>
    <action>
      <description value="Will reduce dosage"/>
    </action>
    <action>
      <description value="Risk of overdose carefully considered and outweighed by benefit snooze 3 mo"/>
    </action>
    <action>
      <description value="Acute pain snooze 1 mo"/>
    </action>
    <action>
      <description value="N/A - see comment (will be reviewed by medical director) snooze 3 mo"/>
    </action>
  </action>
</PlanDefinition>